The present invention relates generally to a kit of resilient blocks specifically configured, when arranged in assembled condition, to properly position and support a patient's spine for surgical procedures and allow free passage of X-rays for visualization. The present invention also relates to an assemblage of blocks releasably secured one to the other in position for supporting a patient in any one of flexion, neutral and extension positions for spinal surgical procedures.
In U.S. Pat. No. 4,398,707, there is disclosed a surgical saddle for positioning and supporting a patient for spinal surgery. In that system, a base pad formed of soft foam rubber is provided with a tapered head extension formed of a similar material. A leg portion, also constructed of soft foam rubber, extends from the opposite end of the base. A pair of laterally spaced ridges are adhesively secured on top of the base portion along its opposite sides for support of the iliac crests of the patient's pelvic bone such that the patient's abdomen and diaphragm hang freely without compression against the spinal area. One of the purposes of that invention consonant with the present invention is to preclude engorgement of interspinal blood vessels to minimize loss of blood during the spinal operation.
However, the system disclosed in that patent does not accommodate patients of different sizes or patients having various conditions of the lumbar spine, such as lordosis. flexion or neutral. For example, a surgeon may wish to position the patient's spine in flexion for a laminectomy such that the intervertebral spaces open up. Another surgeon, however, may wish the patient to be in a lordotic position. The saddle of the previously mentioned U.S. patent cannot accommodate patients of various sizes and shapes including deformities, as well as place the patient in the various required lumbar positions, i.e., the lordosis, flexion or neutral positions. Nor may this device allow for passage of X-rays for visualization.
According to the present invention, there is provided reusable surgical positioning and support apparatus comprised of a plurality of reusable resilient blocks formed to specific shapes and dimensions which, in assembly, properly support a patient's spine for surgical procedures, while allowing the abdomen and diaphragm to hang freely without compression, eliminating interspinal venous engorgement. Certain of the blocks may be alternated to allow positioning in the assemblage in any of flexion neutral and extension positions, while positioning the patient for spinal surgery. The blocks are preferably formed of an elastomer foam having a vinyl-coated outer surface whereby they may be sterilized for reuse. Additionally, the blocks carry hook or loop fasteners at various locations along the blocks such that the blocks may be interconnected one with the other to form the desired shape of the assemblage.
To enable the positioning and support apparatus hereof to accommodate the different sizes and forms of patients, the primary blocks of the kit include a base block (although the base block may be omitted in very small patients), U-shaped block, inside and outside filler blocks, face and chest blocks, and a pair each of flexion, lordosis and neutral blocks, as described in detail hereinafter. These primary blocks may be provided in various dimensions or numbers thereof as applicable for use in combination with one another and other blocks. Thus, the configuration and location of the blocks, and their selection in conjunction with their dimensional relationships, may be used to form an assemblage of interconnected blocks in a predetermined desired configuration to accommodate patients of different size and shape, including patients with deformities, as well as simultaneously affording positioning of the lumbar region for that particular surgery. The assemblage of blocks is preferably mounted on an elongated rigid base board and secured thereto by hook and loop fasteners. The base board may be secured, e.g., by taping, to a standard operating room table "C" arm extensions. In this manner, the patient may be positioned as desired in accordance with the particular surgery to be performed and with the size of the patient.
More particularly, the present invention provides a kit of resilient building blocks for forming the positioning and supporting assemblage. Particularly, a base block is provided having a central opening. The underside of the base block is provided with pile material for connection with hook fasteners provided on the upper side of a rigid base board. Inner and outer filler blocks are provided and each has hook and pile fasteners along its upper and lower sides, respectively. The inner filler block is disposed at one end of the opening through the base block while the outside filler block forms an endwise extension of the base block. Both filler blocks, together with an end portion of the base block, provide support for the superposed face and chest block. Two partial, generally T-shaped, face and chest blocks are preferably provided as part of the kit. One of the face and chest blocks has hook and loop fasteners on its upper and lower faces, respectively, i.e., a lower face and chest block, while the other has only pile on its lower face, i.e., an upper face and chest block. In this manner, the upper or both the upper and lower face and chest blocks may be used in superposition over the filler blocks. A U-shaped block is secured on top of the base block by hook and pile fasteners, the leg of the T-shaped block(s) facing the opening of the U-shaped block. A strap is secured across the legs of the U-shaped block adjacent its open end to assist in maintaining the legs generally parallel one to the other in use and to prevent the legs from spreading in use.
A pair of blocks are disposed on opposite sides of the U-shaped block overlying the side legs thereof. The upper surfaces of these blocks are inclined downwardly toward one another in assembly and provide support for the patient's iliac crests and ribcage. Hook and pile fasteners are used to secure the pair of blocks to the U-shaped block. The kit includes three pairs of such blocks which are selectively used depending upon the desired patient position, i.e., lordosis, neutral or flexion. Thus, the shape of the upper surfaces of the block is specifically designed to effect a certain positioning of the patient's spine as required by the surgeon. For example, the upper surface of the lordosis pair of blocks have convex and concave arcuate portions spaced longitudinally one from the other to dispose the patient in a lordotic position. The pair of flexion blocks has a single convex surface extending from one end to the other to extend the patient's spine. The pair of neutral blocks have a linearly extending upper surface.
The base block and inside and outside filler blocks, are provided in one of two thicknesses or depth dimensions, although additional blocks may be provided in the dimensions as desired. For example, the base block and filler blocks may be provided in 2-inch or 4-inch thicknesses, and blocks of those dimensions are selectively used depending upon the size of the patient. For example, a 2-inch base block would be used for a patient having a height of 5'6" or less, whereas the 4-inch base block would be used for a taller patient. Either the 2-inch or 4-inch filler blocks may be used with either of the 2-inch or 4-inch base blocks depending upon the particular size and shape of the patient. Likewise, one or more of the face and chest blocks may also be used depending upon the particular size and shape of the patient. Consequently, the present invention provides a versatile kit and an assemblage of blocks for both positioning and supporting a patient for spinal surgery and which blocks are adaptable to support patients of different sizes and shapes and to position patients depending upon the desired orientation of the spine for surgery while still allowing unobstructed X-ray visualization of the spine.
Accordingly, in accordance with a preferred embodiment of the present invention, there is provided an assemblage for positioning and supporting a surgical patient facedown, comprising a generally rectangular base block formed of resilient material having length, width and depth dimensions and a central opening, a generally elongated U-shaped block formed of resilient material having a base and a pair of leg portions extending from the base defining a central opening and length, width and depth dimensions, means for releasably securing the U-shaped block and the base block one to the other with the U-shaped block superposed on the base block and the openings in registration one with the other, a face and chest block formed of resilient material superposed at least in part on the base block adjacent the end of the U-shaped block remote from the base for receiving the face and chest of the patient, a pair of elongated blocks formed of resilient material superposed on the legs of the U-shaped blocks to define a space laterally therebetween in registry with the openings in the U-shaped block and the base block, each of the pair of blocks having an upper surface inclined generally inwardly and downwardly toward one another whereby the abdomen and diaphragm of the patient may depend freely in a direction toward the spaces and openings and means for releasably securing the pair of blocks and the U-shaped block one to the other.
According to another aspect of the present invention, there is also provided a kit for assembling surgical support and positioning apparatus for a surgical patient, comprising a generally rectangular base block formed of resilient material having length, width and depth dimensions and a central opening, a generally elongated U-shaped block formed of resilient material and having a base and a pair of leg portions extending from the base, the U-shaped block having length, width and depth dimensions, means carried by at least one of the base block and the U-shaped block for releasably securing the base block and the U-shaped block one to the other, with the U-shaped block in superposition relative to the base block, a face and chest block formed of resilient material for superposition at least in part on the base block adjacent the end of the U-shaped block remote from the base block for receiving the face and chest of the patient, a pair of elongated blocks formed of resilient materials for superposition on the legs of the U-shaped block to define a space laterally therebetween in registry with the openings of the U-shaped block and the base block, each of the pair of blocks having an upper surface inclined generally inwardly and downwardly toward one another when superposed on the U-shaped block and means carried by one of the U-shaped block and the pair of blocks for releasably securing the pair of blocks and the U-shaped block one to the other.
Accordingly, it is a primary object of the present invention to provide a novel and improved kit and an assemblage of resilient blocks for positioning and supporting a patient for spinal surgery which accommodates patients of different sizes and shapes and the surgeon's requirement for different positions of the patient's spine presented for spinal surgery while enabling X-ray visualization of the spinal region during the surgical procedure.
These and further objects and advantages of the present invention will become more apparent upon reference to the following specification, appended claims and drawings.